Major Medical

AETNA US HEALTHCARE 
P.O. Box # 981109
El Paso, Texas 79998-1109 
1-877-223-1685  
Aetna is your major medical coverage and is provided to you by the Mahopac Central School District via the Putnam/Northern Westchester Health Benefits Consortium. Aetna & the Putnam/Northern Westchester Health Benefits Consortium are not administered by the MTA Benefit Fund; this information is provided as a courtesy to you.

Any questions pertaining to health insurance may be directed to: 
Mahopac Central School District  1-845-628-3415 x354

For more information contact:
Putnam/ Northern Westchester Health Benefits Consortium, you may contact:
200 BOCES Drive
Yorktown Heights, NY 10598
914-248-2456 or 2459
914-962-6819 (fax) 
The Mahopac Teachers Association Benefit Fund will reimburse the member a portion of his/her out-of-pocket major medical deductible incurred on behalf of the member and/or his/her eligible dependents, once during a calendar year. This benefit will be paid upon reaching the deductible or at the end of the calendar year whichever comes first.

To obtain this benefit, the member must submit all necessary major medical statements showing the date, doctor or hospital, and event for which the deductible was used and submit them with the Benefit Fund claim form within 90 days of reaching the deductible or the end of the calendar year, whichever comes first. Completed forms should be mailed to:

Mahopac Teachers Association Benefit Fund
c/o Preferred Group Plans
P.O. Box 15136
Albany, NY 12212-5136
A guide to health care payment terms

Let's face it. Health plans can be confusing, especially when it comes to figuring out what you need to pay for care. Here are three terms that may apply to your health plan.
  • Deductible. This is the amount you pay for covered care before your health plan starts to pay. Many plans have a yearly deductible. For example, if your plan has a $2,000 yearly deductible, you may need to pay $2,000 before your plan pays any expenses.*
  • Co-pay. This is the set dollar amount you pay for covered health care services. For example, you pay a set dollar amount to your doctor for an office visit. If your co-pay is $40, you pay that amount when you see your doctor. If your plan has a co-pay, you would typically pay it after you pay your deductible limit. In a pharmacy plan, the co-pay is the amount you pay for covered drugs.*
  • Co-insurance. This is the percentage of health care expenses you need to pay after you reach your deductible limit. For example, if your co-insurance is 80 percent, your plan will cover 80 percent of eligible costs up to any benefit or lifetime maximum. You would pay 20 percent.*
*The costs and/or percentages noted in this example are for descriptive purposes only. Your actual costs will vary by employer, plan and the state where you live.

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